Kalia Phillips, DPT

Individual provider Active NPI Physical Therapist · Southlake, TX

NPI 1699588103 · NPPES record last updated Jan 29, 2025

Key facts

NPI
1699588103
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
1403070 (TX)
Practice address
180 State St Ste 225
Southlake, TX 76092-7632
Phone
(866) 839-6979
Fax
(916) 913-5646
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Luna Care Physical Therapy LLC (18 clinicians)
Texas Luna Care Physical Therapy LLC (271 clinicians)
Baylor College of Medicine (1,230 clinicians)

Practice addresses (Care Compare)

14050 N 83Rd Ave
Suite 290
Peoria, AZ 85381-5650
Phone (866) 525-3175

180 State St
Suite 225
Southlake, TX 76092-7632
Phone (866) 525-3175

7200 Cambridge St
FL 10
Houston, TX 77030-4202
Phone (713) 798-1000

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX, AZ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250203003497 TX Practitioner - Physical Therapist in Private Practice 0648700864 Reassigns benefits to 2 organizations
I20260626002591 AZ Practitioner - Physical Therapist in Private Practice 0648700864 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
11817LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Luna Care Physical Therapy LLC Physical Therapist Current
since Jan 30, 2025
Accepting new patients
Baylor College of Medicine Current
since Jan 30, 2025
Accepting new patients
Baylor College of Medicine Current
since Jan 30, 2025
Accepting new patients

Locations

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11817 LA
Physical Therapist 225100000X 1403070 TX Yes

Addresses

Primary practice location

180 State St Ste 225
Southlake, TX 76092-7632

Mailing address

180 State St Ste 225
Southlake, TX 76092-7632
Phone (866) 839-6979

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 29, 2025.

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1699588103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 STATE ST STE 225",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927632",
            "telephone_number": "866-839-6979",
            "fax_number": "916-913-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 STATE ST STE 225",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927632",
            "telephone_number": "866-839-6979",
            "fax_number": "916-913-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KALIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11817",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1403070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

All providers in Southlake, TX · Physical Therapist in Texas

Sources for this page

Verify at the official NPI Registry.